title: Value of MRI in local staging of bladder cancer.
abstract: OBJECTIVE
  To evaluate the accuracy of magnetic resonance imaging (MRI) in bladder cancer staging as well as differentiating superficial from invasive tumors and organ-confined from non-organ-confined tumors.
  
  
  METHODS
  A total number of 108 bladder tumors in 86 patients (86% men and 14% women) were evaluated by 1.5 Tesla MRI machine. The tumor stages that were determined by MRI study were compared with pathology results after resection of the tumor.
  
  
  RESULTS
  The most common stage determined by both MRI and pathology was T2a. Considering stages in details, the kappa agreement coefficient between MRI and pathology was 0.8 (P < .0001). Combining groups a and b in each stage, the kappa agreement coefficient between MRI and pathology was 0.87 (P < .0001). Considering stages in details, we had 22 (20.3%) mismatches in staging between MRI and pathology; 10 (45.5%) were underestimation and 12 (54.5%) were overestimation. Combining groups a and b in each stage, we had 14 (13%) mismatch cases; 6 (46.2%) were underestimation and 8 (53.8%) were overestimation. The detection rate of MRI was 0% in stage Ta, 80% in stage T1, 88.1% in stage T2, 81.2% in stage T3, and 100% in stage T4. The sensitivity and specificity of MRI in differentiating superficial from deep tumors were 0.98 and 0.82, respectively. The sensitivity and specificity of MRI in differentiating organ-confined from non-organ-confined tumors were 0.93 and 0.94, respectively.
  
  
  CONCLUSIONS
  Magnetic resonance imaging is a reliable modality for determining the stage of bladder tumors with high accuracy, and could show the depth of invasion and extension of tumor that is useful for treatment planning.
authors.affiliation: Department of Radiology, Hazrat Rasoul Akram University Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. mahyarghafoori@gmail.com
authors.forename: Mahyar
authors.initials: M
authors.lastname: Ghafoori
authors.forename: Madjid
authors.initials: M
authors.lastname: Shakiba
authors.forename: Atefeh
authors.initials: A
authors.lastname: Ghiasi
authors.forename: Nazanin
authors.initials: N
authors.lastname: Asvadi
authors.forename: Kamal
authors.initials: K
authors.lastname: Hosseini
authors.forename: Manijeh
authors.initials: M
authors.lastname: Alavi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis*